Post- to pre-overnight sleep systolic blood pressures are associated with sleep respiratory disturbance, pro-inflammatory state and metabolic situation in patients with sleep-disordered breathing.
OBJECTIVE
The aim of the current study was to investigate whether changes in post- to pre-overnight sleep systolic blood pressure (SSBP) are associated with sleep respiratory disturbance, pro-inflammatory state, and metabolic situation in patients with sleep-disordered breathing (SDB).


METHODS
Anthropometry, sleep polysomnography, biochemical markers, and pre- and post-overnight sleep BP were measured from 263 SDB patients. All SDB patients were further subgrouped into MORNING SURGE (% changes from post- to pre-overnight SSBP >+1SD of this cohort), MORNING DROP (% changes <-1SD), CONSTANT HIGH (% changes within+/-1SD, averaged SSBP>130mmHg) and CONSTANT LOW (% changes within+/-1SD, averaged SSBP<130mmHg).


RESULTS
BMI, neck circumference, waistline circumference, respiratory disturbance index, arousal index, lowest oxygen saturation, duration of SaO(2)<90%, blood glucose, hs-CRP, and metabolic syndrome score in MORNING SURGE and CONSTANT HIGH were significantly greater than those in CONSTANT LOW. Except metabolic syndrome score, all other parameters in MORNING DROP were similar to those in CONSTANT LOW.


CONCLUSIONS
Patients with SDB whose post- to pre-overnight SSBPs were elevated or maintained a constant high have more sleep respiratory disturbance, more pro-inflammatory state, and higher metabolic syndrome indices than the rest. Without subdividing into CONSTANT LOW, MORNING DROP, CONSTANT HIGH, and MORNING SURGE, the important pathophysiologic points of SDB patients will possibly be missed.
Ting
Hua
H
Department of Physical Medicine and Rehabilitation, Chung-Shan Medical University Hospital, Chung-Shan Medical University, Taichung, Taiwan.
Lo
Hsiao-Sui
HS
Chang
Shu-Yun
SY
Chung
Ai-Hui
AH
Kuan
Pai-Chuan
PC
Yuan
Su-Chuan
SC
Huang
Chien-Ning
CN
Lee
Shin-Da
SD
D000886:Anthropometry; D015415:Biomarkers; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology*; D002097:C-Reactive Protein / Q000378:metabolism; D002940:Circadian Rhythm; D004569:Electroencephalography; D004576:Electromyography; D004585:Electrooculography; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000378:metabolism*; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000378:metabolism*; D008875:Middle Aged; D017286:Polysomnography; D017382:Reactive Oxygen Species / Q000378:metabolism*; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000453:epidemiology* / Q000503:physiopathology*; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000453:epidemiology*; D012894:Sleep Stages; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*; D055105:Waist Circumference / Q000502:physiology
D015415:Biomarkers; D001786:Blood Glucose; D015850:Interleukin-6; D017382:Reactive Oxygen Species; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein